NEWS AND VIEWS: The living, the dead, and our society's priorities (08/01/99)

NEWS AND VIEWS

The living, the dead, and our society's priorities

by Alex Kuzma

For seven heartbreaking days in July, millions of Americans and millions of caring people around the world were riveted by the tragic fate of John F. Kennedy, Jr., his wife, Carolyn, and sister-in-law, Lauren Bessette.

The Navy and the Coast Guard went to extraordinary lengths and spared no expense to recover the bodies of the three young Americans whose lives held so much promise, but were lost in an instant off the coast of Martha's Vineyard. Even after the first two days, when virtually all hope of ever finding the victims alive was gone, the recovery effort continued.

There are times where human compassion defies logic, when our desire to change fate for the better seems totally out of proportion with the minimal results our efforts can possibly achieve. "Closure for the families" was the ultimate goal of recovering the three bodies, even though the purpose was only to cremate them and re-bury them at sea. Yet for the millions of people around the world who shared in some small way the Kennedy and Bessette families' sense of bereavement and the gratitude for the Kennedy family's decades of public service, the expense of the recovery effort seemed reasonable. It brought solace and dignity to a tragedy that was otherwise senseless and emotionally shattering.

Against the backdrop of the Kennedy tragedy, it is worth questioning the attitude held by many members of our diaspora who seem resigned to give up on the fate of tens of thousands of Ukrainian children and young people whose lives are hanging by a thread today. According to the most recent feature on Ukraine published in The New York Times, the official rate of infant mortality in Ukraine is 21 per thousand - more than three times the European average. In just the last five years, Ukraine experienced a net loss of more than 2 million citizens as death rates have exceeded live births by hundreds of thousands. Among young adults, the rates of breast cancer, suicide, thyroid cancer and AIDS are rising sharply and, barring a multitude of miracles, it is only a matter of time before Ukraine's population takes another demographic plunge.

Statistics are always sterile and numbing. It is easier to relate to the death of a trio of prominent and attractive Americans whose faces graced the cover of People Magazine than it is to appreciate the plight of thousands of Ukrainians whose faces we have never seen and whose lives are unfamiliar to us. Yet, beyond the chilling statistics, there is the heartbreak of thousands of individual and destitute families who are forced to grieve the loss of a child knowing full well that in any developed country, with proper technology and treatment, that child might have survived.

The loss of a child has to be the worst scourge a family can suffer. It is the ultimate test of a family's strength and its fidelity to God's teachings. The trials of Job were based on a wager between God and the devil that a loving and prosperous father could endure the sudden loss of his family without losing faith in God's mercy.

The tragedy of health care in Ukraine lies in the fact that, in most cases, the untimely deaths of children are not acts of God. They are something less mysterious than bizarre or cruel twists of fate. They are entirely preventable.

And therein lies the irony. We agonized over the fate of the Kennedys and Lauren Bessette, even though we were entirely helpless to reverse the outcome. Their lives were deemed so precious that even in death they were afforded a level of care and devotion, and a commitment of resources, that staggers our imagination. The fate of thousands of newborns, children and adolescents in Ukraine can still be reversed. Yet, much of the diaspora has been so demoralized by the enormity of this task that it seems ready to shrug off the lives of these youngsters long before their fate has been sealed.

The formulas for improving public health are well-developed in the West - through community health programs, radical improvements in hospital procedures, advances in technology and physician training. There is a growing cadre of Ukrainian doctors at the grassroots level who have shown they are capable of applying these advances for the benefit of their patients and, given the proper technology and training, they are capable of achieving quantum leaps in the quality of care they provide.

A few examples bear mentioning:

In Lviv there is a talented young pediatric surgeon named Roman Kovalsky, who received extensive training in the United States. Had he decided to stay here Dr. Kovalsky could be earning hundreds of thousands of dollars each year as a surgeon in a prestigious medical center such as Boston Children's Hospital or the Deborah Heart and Lung Center, where he trained. Instead, he returned to his hospital in Lviv where, despite a dearth of resources, he has improvised life-saving operations on children born with various defects of the esophagus and the intestinal tract.

For the miracles he has performed, Dr. Kovalsky receives (when he's lucky) less than $200 a month. Dr. Kovalsky could save many more children's lives each year if he had a heart/lung machine that would enable his team to perform open heart surgery on children with cardiac defects. The cost of such a machine is under $200,000.
In Kyiv, there is an MRI system delivered in 1994 by the Ukrainian National Women's League of America and the Children of Chornobyl Relief Fund. After five years of continuous operation, this MRI has provided diagnostic tests for nearly 10,000 patients. It has located nearly 1,000 malignant tumors - most of which were removed at an early and treatable stage - and it has enabled doctors to perform effective treatments of traumatic head injuries and other life-threatening conditions. That MRI will soon need to be replaced. At a cost of $350,000 this may seem like an exorbitant investment until we realize that other foreign aid programs have spent millions of dollars on fact-finding missions and glossy reports, but produced few if any measurable results.
In Dnipropetrovsk, Lutsk and other cities, neonatal intensive care units established by American donors have enabled doctors to reduce the infant mortality rate by one-half to one-third in several hospitals while expanding services to newborn infants with various complications.

The United States and the Ukrainian diaspora have the resources to make an enormous difference in the lives of thousands more children and families. The question is, do we have the resolve to do it?

Ukraine's health crisis is complicated by many factors: Chornobyl, the staggering economy, social upheaval. But there is another specter stalking the country that urgently needs to be addressed. Not long ago in Donetsk, five children in the same ward were contaminated with HIV during blood transfusions because local hospitals do not have the technology to test for the deadly AIDS virus. The rate of AIDS infections in Ukraine is the fastest-growing in Europe, with over 35,000 confirmed cases. The total incidence remains low compared to many other countries, but this makes it all the more imperative to act quickly, before Ukraine is overwhelmed by a full-blown AIDS crisis. Literally tens of thousands of lives hang in the balance.

The examples cited above provide just a fleeting glimpse of the tremendous potential that lurks in our community. Obviously, the diaspora cannot be expected to carry the weight of the entire Ukrainian health care system. The Ukrainian government and Ukraine's fledgling private sector will have to be shamed into assuming more responsibility for the deplorable state of health care in the country. But already, we have seen cases where quality aid delivered from the West has helped stimulate the creation of progressive health centers in Vinnytsia, Lviv and Kyiv, and even small towns like Krasnyi Luch in Luhansk Oblast, with the support (as opposed to the obstructionism) of local authorities.

It will require much more than clothing drives and emergency deliveries of pharmaceuticals to make a difference. If the United States can commit its finest technology to recover dead bodies and plane wrecks from the ocean floor, then surely we can be more generous with the funds, technology and training needed to actually save the lives of youngsters, whose future is crucial to America's national security interests.

After the latest Kennedy tragedy, the consensus of most Americans was that there is nothing perverse or exorbitant about devoting tremendous resources to recover the body of a former president's son. A proper burial for the dead is, after all, an act of mercy. But we can all agree that there is something perverse and horribly wasteful in giving up on the living while opportunities to save them still abound.

As the next anniversary of Ukraine's independence approaches, the opening words of its national anthem need to be restated in this context: "Ukraine has not yet died." Neither have its talent, its children, its future. But the time to act is now, before an entire generation is decimated by disasters man-made and preventable.

Alex Kuzma is director of development for the Children of Chornobyl Relief Fund.

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